GARCIA: Respect health-care workers

Protect personal rights and professional livelihoods

By Joxel Garcia | Wednesday, September 17, 2008

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OP-ED:

There is no more sacred right than the right of conscience - the right to be guided by one's own cherished beliefs and moral convictions. In certain professional fields, like health care, questions of conscience are particularly likely to emerge. Thus, in most situations health-care workers have the right - under the law - to abstain from performing actions that violate their conscience. But this right has recently come under attack.

As a long-practicing OB-GYN, I can personally attest to the need for greater awareness and protection of health-care workers' rights under the law. Not once during my entire span of medical training and practice did anyone reference my legal rights to abstain from performing actions that contradicted my conscience. In reality, many health-care workers routinely face pressure to perform actions that violate their personal convictions.

On several occasions in the past three decades, Congress has passed laws protecting health-care workers' ability to act consistently with their rights of conscience. But there is mounting pressure to disregard these laws.

Thankfully, the U.S. Department of Health and Human Services (HHS) has just proposed a regulation to increase awareness of and compliance with the law. When, some time after a 30-day period for public commentary (through Sept. 25), this regulation is officially adopted by HHS, many health-care workers will benefit from clearer guidance and better enforcement of the law, and they and won't have to sacrifice their personal convictions to preserve their professional livelihoods. And the regulation would secure institutions' rights under the law as well.

This should be viewed as a positive development and a welcome point of agreement across the political spectrum. Instead, it is being criticized by people who seem to think that health-care workers should be compelled to perform certain medical services against their will.

One prominent pro-abortion advocate was recently quoted by Congressional Quarterly as saying that "it's really not acceptable to the people I represent that this administration is considering allowing doctors and nurses and pharmacists that have received their education to provide services to now be able to not provide those services if they don't want to."

What is truly not acceptable is forcing health-care workers to provide services that violate their deeply held beliefs. Existing law makes clear that a person does not forfeit the right to follow his or her conscience upon the issuance of a medical or nursing degree.

Health-care providers are not merely the equivalent of vending machines, robotically providing a service once they receive enough money - and thankfully so. Like most Americans, I expect a high standard of care for myself and my family, and I cherish the freedom to choose a provider who shares my convictions.

Some critics suggest that health-care workers with strong, personal convictions should simply get out of the medical field. Such a narrow-minded view shows a lack of concern not only for health-care workers but for patients and their health. This is the last thing we need as we face a crippling shortage of workers - particularly OB-GYNs. Instead, the wise approach is the one that has already been established by law: to respect health-care workers' rights to abstain from actions that violate their conscience, and to respect institutions' rights as well.

The HHS proposed regulation would require entities that receive HHS funds to certify that they will abide by the law and that they will not force health-care workers to perform actions to which these workers object - whether the actions involve abortion or something of an entirely different nature. The overarching principle is the same regardless of the specific action: People should not be forced to provide health-care services that violate their own strongly held convictions.

To be clear, nothing in the proposed regulation in any way threatens a patient's ability to receive any legal service. At the same time, nothing in the decisions of the Supreme Court or in the laws of Congress obligates health-care workers to provide or to participate in every legal service. To the contrary, federal law explicitly shields health-care workers and institutions from such unwanted obligations.

The proposed HHS regulation is fully consistent with Americans' longstanding commitment to the right of conscience and the rule of law, and it should be adopted.

Adm. Joxel Garcia is assistant secretary for health with the Department of Health and Human Services.

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